KENNEDY JACKSON
NPI 1205510658
Physician Assistant in Birmingham, AL

Active since June 14, 2023PECOS Enrolled
1716 9TH AVE S, BIRMINGHAM, AL 35233(502) 759-6531 Get Directions Write a Review

NPPES record last updated: June 14, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kennedy Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNEDY JACKSON (NPI 1205510658) is an individual physician assistant in Birmingham, Alabama and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1205510658
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKENNEDY JACKSON
Location Address1716 9TH AVE SBirmingham, AL 35233-1124
Mailing Address1305 31st St S Apt 301Birmingham, AL 35205-2039 · (502) 759-6531
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJune 14, 2023
NPPES CertifiedJune 14, 2023
NPI 1205510658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1716 9TH AVE S, Birmingham, AL 35233

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Kennedy Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8921591793
PECOS Enrollment IDI20251202000603
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35233 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
1716 9TH AVE S
BIRMINGHAM, AL 35233
Student in an Organized Health Care Education/Training Program
1716 9TH AVE S
BIRMINGHAM, AL 35233
Physician Assistant (Surgical)
1716 9TH AVE S
BIRMINGHAM, AL 35233
Occupational Therapist
1716 9TH AVE S
BIRMINGHAM, AL 35233
Physician Assistant
1716 9TH AVE S
BIRMINGHAM, AL 35233
Physician Assistant
1716 9TH AVE S
BIRMINGHAM, AL 35233
Physician Assistant
1716 9TH AVE S
BIRMINGHAM, AL 35233
Student in an Organized Health Care Education/Training Program
1716 9TH AVE S
BIRMINGHAM, AL 35233

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kennedy Jackson's NPI number?

The NPI number for Kennedy Jackson is 1205510658. It was assigned to this individual provider in the NPPES registry on June 14, 2023.

Where is Kennedy Jackson located?

Kennedy Jackson practices at 1716 9th Ave S, Birmingham, AL 35233. The listed phone number is (502) 759-6531.

What is Kennedy Jackson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kennedy Jackson enrolled in Medicare?

Yes. Kennedy Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kennedy Jackson was last updated on June 14, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.